This is Laura Diet with the Becker Health
care podcast.
I'm thrilled today to be joined by Hill
Martin Res, President and Chief Executive Officer of
Uc care. Hillary is a pleasure to have
you on the podcast today?
It's a pleasure to be here, Laura. Thank
you so much for the invitation.
Now, I'm really looking forward to learning more
about
you and how you're thinking about growth and
development at Uc care. But before we dive
in, could you please introduce yourself, tell me
a little bit more about uc care as
well?
Yeah. Of course. Happy to do Laura. So
I have been at Uc care since 20
10, but in the proud president and Ceo
since 20 21.
Uc care is a Minnesota based health plan
serving individuals who get their coverage through government
health program. So that includes Medicaid, Medicare and
products for those who are dual eligible for
Medicare Medicaid as well as Minnesota state based
exchange marketplace.
We don't offer employer based commercial coverage, all
we do is government programs, and this allows
us to be singular focused on the unique
needs, of the individuals we serve.
For a profit plan, mission base where community
plan and it's our forties
anniversary this year, Laura, we are celebrating
anniversary this summer. In fact.
We were founded in 19 84 by a
team of providers whose thought there must be
a better way or to serve individuals who
are eligible for Medicaid.
And they started in a single county and
they strive to improve access to outcomes and
equity for the,
Medicaid members in this
demonstration project.
So while we started as a demonstration project,
it's clearly been a very successful
demonstration because we are still here 40 years
later, now serving about 600000
members. In every county in Minnesota as well
as portions of Western Wisconsin.
We are now the largest nonprofit government programs
health center in Minnesota and in fact, the
third largest in the country.
And
according to a recent Usa today,
publication, we are the highest ranked health plan
in the nation among
plans of ever size as it relates to
employee engagement and workplace culture.
We are really proud of this. In fact.
We call this our people power.
That's amazing to hear. And you know, wow.
What a great anniversary... 40 years this summer.
That's a huge accomplishment and so exciting to
hear about how you've continued to evolve over
the years and serve the community better. Now
from your perspective, what are some of the
big trends and headwind that you're following right
now?
Yeah. Well, it's a great question, Laura. You
know, every business as you know, it's focusing
on the role of Ai in the organization.
Ai has the potential to be the biggest
innovation to hit healthcare and frankly to hit
any industry in years, probably in our lifetime.
Ai creates incredible opportunities in areas such as
predictive modeling and simplifying member experience.
More efficient operations and so much more. But
as you know, it also comes with risk.
Ai can bring about unintended concepts
such as introducing bias and discrimination into decisions,
potentially ex the health disparities that already exist
and of course, there can be privacy concerns
and security concerns and even ethical and moral
concerns.
And of course, Ai introduces the possibility of
regulatory
and legal challenges. And
as you know, the health industry has already
seen some of both. The At uc care,
we have a team of people leading this
work, which is oversee by a committee of
our board to ensure it gets the highest
level of over site. So as we build
our Ai approach at Uc care, we are
being very deliberate
about introducing Ai in a way that it's
aligned with our mission site and that directly
benefit our members and provider.
And we're ensuring that it aligns with our
non nonprofit value in our strong workplace culture.
We've also been unwavering in our commitment to
using Ai in a way that enhances what
makes the special and doesn't ever replace it.
In other words, we'll ensure that we don't
replace the human element of our service
or the human element of the positive experience
we create with our members.
The human re element of the relationships we
have with our partners
or especially the human element of the thoughtful
decision making that we
make every single day.
But we're also unwavering our commitment that any
use of Ai will be responsible
and ethical all the time. Every time without
exception exception.
And we're being just as deliberate, Laura about
ensuring that we avoid the common tip pitfalls
that can be associated with the use of
Ai and help care. For example, let's talk
for a moment about how Ai may support
prior
authorization process. Uc care already limits the use
of Pa to only those services that may
be unsafe,
unnecessary or redundant for members or those services
that lack evidence based criteria
or documented improvements.
Our intent is always to minimize member disruption
and provider burdens and never to delay access
to needed care.
So will limit the use of Ai and
prior authorization to being a decision support tool
to help ensure consistent
application of medical necessity criteria, but it will
not be used to deny cure. Any questions
about whether care is necessary or appropriate will
you evaluate a any case by case basis
by our clinical
professional.
Laurie you also asked about headwind, that Care
and other organizations are facing. So in terms
of the headwind,
every
organization, especially healthcare
organizations that are experiencing the impact of the
largest
cybersecurity breach in the nation's history.
Healthcare is a popular target for cyber criminals
unfortunately
and this recent breach reminded us of the
vulnerabilities of our interconnected systems and processes
and the need to be ever vigilant and
staying ahead of cyber cybersecurity threats.
It was also a reminder to have strong
business continuity plan, callback connection it's not just
solely depend on a single vendor for essential
services.
At Care, we're proud of the proactive steps
we've taken over the years,
to build business continuity programs and to safeguard
our systems in our data and will continue
to prioritize this work going forward.
That's great to hear it. In such a
good reminder of so many different factors that
have an impact on how operations work in
and can really, be thoughtful approach to, as
you mentioned Ai as well as cybersecurity and
some of the other risks that are are
ahead of us. No. It's I'm wondering how
are you thinking about growth for the future?
What does that mean for you at uc
care?
Yeah. I I appreciate that question, Lauren. This
first talk generally about their business reasons that
many organizations speak to grow. First, of course,
as organizations grow against scale. Which allows them
to operate more efficiently and effectively and contribute
to their bottom line
and girls for organizations can also lead to
product
diversification or geographic
diversification, which allows organizations to have a broader
portfolio of business signs that further supports the
organizational health.
When we think about growth at You care,
we're not just thinking about the business value
of growth, although those are of course important.
But as a highly mission driven
nonprofit community plans, our primary
motivation for girls is to allow more individual,
benefit from a unique programs and services
that we offer to our health plan numbers.
Let's talk about Medicaid, for example.
To As I said earlier, we've been serving
Minnesota eligible for Medicaid for 40 years. And
we serve more Medicaid enroll in Minnesota that
any other plan about... 400000
minnesota.
So we've developed, signed and innovated our Medicaid
offerings over the decades,
enabling us to serve our Medicaid members with
an expertise that's based on years of
with providers
meeting
organizations and government partners, to respond to their
very localized needs.
We like to say that we're the bridge
between a complex Medicaid system and the communities
we serve.
So, Laura, when we talk about growth, we
think it's equally important to talk about what
we are not going to do as it
is to talk about what we will do.
First, we will never lose sight of the
important work we do in Minnesota. We've been
serving minnesota for decades and that will never
change.
The growth efforts will not distract us from
continuing to serve to partner to innovate in
our current market.
Second, as we explored growth including geographic expansion,
we won't simply replicate what we do in
Minnesota in new markets.
We're proud of what we've accomplished in Minnesota.
So what certainly will be elements of those
capabilities that will form the foundation in new
markets.
But we're a community plan and that means
we don't have an initial playbook.
Even when we grow and we're eventually operating
in multiples days, we'll never have a national
playbook because we customize our approach based on
the specific needs of the communities in which
we operate.
As I said, we'll leverage what was learned
in Minnesota, but we'll never come paste it
into a new market.
And also, Laura, we don't make assumptions about
what local communities needs. When we talk about
being a community based plan. It means that
we learn about those needs, but asking communities
about their experiences,
we ask them about their challenges and their
priorities,
and then we c create solutions,
with them to meet their.
Finally,
we will never let go of our culture,
which as I said before, we call it
our people power.
People come to you care because they believe
in our mission and then they stay because
they see they feel the impact that they
having honor our members. And our commute every
single day.
When I started at Uc care, Laura in
20 10 and we had
we were much smaller. We now have 4
times more employees than we had in 20
10. And despite that tremendous growth, we've never
lost sight of our mission for our values
in our culture and we remember will, even
as we grow over the years.
That's amazing here. And, you know, I really
love the idea of continuing to build upon
that culture and and really valuing the people
within the organization and and seeing how they
can drive success.
And and 2, another thing that you said
that stood out to me was the idea
of personalization being able to really embrace any
community that you're working in, understand the intricacies
and nuances and then customizing your approach, in
in way your,
best being able to serve people of that
community. I think that's so powerful and something
broadly in health care. I hear more and
more about on a regular basis. This is
just having that type of personalization and customization,
really really is
beneficial and keys. So that's great to hear
is already baked into a part of who
you are in in the mission of uc
care,
before I wrap up here, I'm wondering, could
you tell me about a project or initiative
from the last year that's yielded the best
results?
Yeah. Thank you for that question, Laura. There
there's so many successes that I'm proud of
as I reflect on the past year ranging
from things like
population health initiatives. That are moving the dial
and addressing health disparities,
the large technology
implementations and so much more. But what I'd
like to share with you today is the
work we did in support of the Medicaid
red
process.
As the largest Medicaid plan in Minnesota, we
felt we had both an opportunity and a
responsibility
to ease the burden of this process
on the members
within in our state. And so our planning
work started well below before the public health
emergency ended.
So we had additional support and services ready
to go on day 1. For example,
We expanded an existing internal team that we
have at U care that we called our
Key coverage team.
This team connected 1 on 1 with some
of our highest risk members to help them
complete their renewal
application.
We also partnered with a local navigator
increase our capacity for this 1 on 1
assistant.
And taken together, we were able to have
more than 50000
member touch point related to the renewal process
over the past year.
We did additional things like c developing
educational materials and partner of with Minnesota Permanent
human services,
and we educated members about renewal requirements using
linguistic and culturally appropriate
messages and approaches.
We helped fund assistance program that providers and
community agencies, and we sent them information about
which of their patients, our members, they
are impacted, so they could provide personalized support
from their perspective. For example,
we offered some grants to help some providers
have staff available to support renewal process
and application questions where their patients came in
for a doctor's appointment.
And then we had a community wide marketing
strategy that included targeted digital marketing as well
as Tv ads featuring uc care employees helping
people with fair renewal.
The red
process was uncharted territory for everyone involved. So
it was important to be nimble and be
ready to adapt continual change through Alta traffic.
So we worked closely with our partners to
adjust and evolve our model to best serve
our members throughout what was a 12 month
process in Minnesota.
So as the process wraps up in Minnesota,
we're still analyzing the total impact Member, but
we believe that you care exceeded both local
and national projections in terms of the percentage
of members that we retain.
Mostly in a Medicaid program, but some in
1 of the products we offer through our
state's marketplace, where as you know, monthly premiums
are often offset by subsidies to make those
products more affordable.
We're still grateful for our strong partnership with
a state to achieve these results, as well
as our partnerships with providers, counties and community
organizations. And of course,
none of this would have been possible without
the strengths of the nearly
1700
extraordinary employees or for Uc care, which, as
I said before we call our people power.
I love that. Hillary. Thank you so much
for joining us on the podcast today. This
has been a fascinating discussion. I've learned a
lot and really appreciate. The time that I've
had with you today. Thank you so much,
and I look forward to connecting you again
soon. Thank you, Laura.